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Does This Lab Report Indicate The Presence Of Kidney Disease?

Posted on Mon, 28 Sep 2015

Question: If a patient with a history of CKD has a normal creatinine and BUN and a GFR > 60, and a urine output of 800 to 1000 ml per 12 hr shift but has an IV of NS at 100cc/hr and is on a diet with liquids is positive a liter or 2 for 24 hrs, is this cause for
worry about renal function? Or, are labs the best determination of renal function?

Answered by Dr. Rakesh Madhyastha (7 hours later)

Brief Answer:
Renal function

Detailed Answer:
Hello

Here is how you tell if someone as renal dysfunction

1. Serum creatinine should be less than 1.2 mg/dl
2. No protein loss in urine or rbc in urine
3. Normal sized kidneys on ultrasound

The best way of measuring the renal function is be getting creatinine clearence done another way is to get a DTPA scan done

I hope I was of help, if you have any further queries please get back to me

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (8 hours later)

If you were just given the information that I wrote, would there be a concern from a renal standpoint?

Answered by Dr. Rakesh Madhyastha (12 hours later)

Brief Answer:
Would be worried

Detailed Answer:
Hello

Thanks for getting back

From the information you have given I wouldn't be worried as a nephrologist as gfr is good and there is adequate urine output.

It is important that you are ace/arb at this point. I usually start telmesartan 20-40 mg once a day

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (14 hours later)

Thanks,

Your brief answer "Would be worried", was that a typo? as in your detailed answer you "wouldn't be worried".

I believe the pt was on lopressor and/or hydralazine.

Answered by Dr. Rakesh Madhyastha (8 hours later)

Brief Answer:
Typo

Detailed Answer:
Hello

I am sorry for the typo, iPhones have a mind of their own.

Along with Lopressor and hydralazine I recommend that the patient is on ACE/ARB. It has been proven time and again that ACE/ARBs are renoprotective and cardioprotective as well.

Regards

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar